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Clin Med II > GI Diagnosis > Flashcards

GI Diagnosis Flashcards

1
Q

Type of diarrhea that ↓ with fasting, <1 L vol and has > 50 osmotic gap

A

Osmotic

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2
Q

Type of diarrhea that persists with fasting, >1 L vol daily and may have small osmotic gap

A

Secretory

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3
Q

Type of diarrhea that hass >6 x daily bowel mvts
Stool with mucus and blood
Volume <1 L daily

A

Exudative

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4
Q

Strawberry gallbladder

A

Cholesterolosis

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5
Q

RF for Cholelithiasis

A

fat, fertile, female, forties

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6
Q

MC etiology of Cholelithiasis

A

cholesterol

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7
Q

MC location of Acute Cholecystitis

A

Cystic duct/neck obstruction

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8
Q

Hallmark of Chronic Cholecystitis

A

Rokitansky-Aschoff sinuses

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9
Q

MC gallbladder carcinoma

and MC location

A

MC Adenocarcinoma

fundus or body > neck

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10
Q

What causes pancreatic pseudocysts?

A

massive liquefactive necrosis

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11
Q

MC location of pancreatic neoplasms

A

head of pancreas

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12
Q

What diagnostic test should you do for ductal adenocarcinoma?

A

Endoscopic retrograde cholangiopancreatography

(ERCP) with aspiration cytolog

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13
Q

What diabetes is insulin dependent?

A

Type 1 DM

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14
Q

Absolute deficiency of insulin due to autoimmune destruction of islets

A

Type 1 Diabetes

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15
Q

Relative insulin deficiency and insulin resistance both seen in most cases; after many years, insulin deficiency becomes severe

A

Type 2 Diabetes

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16
Q

Dysphagia

Ring of mucosal tissue in the distal esophagus which can cause narrowing and dysphagia

A

Schatzki’s Ring

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17
Q

Dysphagia

fullness, gurgling, coughing, aspiration, regurgitation of food, obstructive sx

A

Zenker’s Diverticula

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18
Q

Dysphagia
↑ LES resting pressire & inability to relax

Absence of peristalsis in body of esophagous

Dilated esophagous (caused chest pain)

Narrowed distal esophagous (bird’s beak)

A

Achalasia

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19
Q

What is MC cause of esophageal infection?

A

candidias

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20
Q

What is MC cause of gastroduodenal injury in U.S.?

A

NSAIDs

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21
Q

What is the mechanism of NSAID damage?

A

Inhibit prostaglandins through reversible inhibition of both COX-1 (PG are GI protective) and COX-2 (PG mediate pain, inflam and fever) enzymes

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22
Q

Epigastric abd pain worse in AM
Fatigue, black stool
Anorexia, melana, hematemesis, weight loss

A

Peptic Ulcer Disease

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23
Q 
Bloating
N/V
Early satiety
Epigastric pain
Regurgitation of undigested food 
Weight loss
A

Gastroparesis

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24
Q

Major cause of infant morbidity and mortality

Fever, Vomiting, Diarrhea, Dehydration

A

Rotavirus

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25
Q

People in close quarters – cruise ship
Vomiting, abdominal cramps, diarrhea, low-grade fever
Food, water, swimming pools, shellfish (heat- resistant)

A

Norovirus

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26
Q

Diarrhea, headache, nausea

Children < 3 years immunosuppressed adults

A

Astrovirus

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27
Q

Signs of wet beriberi

A 
peripheral vasodilatation
high‐output heart failure
dyspnea
tachycardia
cardiomegaly
pulmonary edema   
peripheral edema
warm extremities 
mimicking cellulitis
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28
Q

Signs of dry beriberi

A

polyneuropathy- affecting leg, footdrop, wristdrop, areflexia

CNS- Wernicke encephalopathy, Korsakoff (or combo)

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29
Q

Signs of Wernicke encephalopathy

A

nystagmus, ophthalmoplegia, truncal ataxia, confusion

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30
Q

Signs of Korsakoff syndrome

A

mnesia and psychiatric manifestations

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31
Q

Esophageal ca etiology

A

Squamous cell carcinoma (Eastern Europe and Asia)

Adenocarcinoma (western Europe)

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32
Q

SB ca etiology

A

adenoCa

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33
Q

Pancreas Cancer etiology

34
Q

Anal Pain
“I’m passing razor blades”
Anal Itching
Outlet Bleeding

A

Anal Fissure

35
Q 
Very painful
Feels like hard pea sticking out
Constant Pain Protrusion
Bleeding
Tender Mass Protrusion

Secondary Findings: skin necrosis, prolapsed Internal, hemorrhoids

A

Thrombosed External Hemorrhoid

36
Q 
Constant Pain
Pressure
Subacute Onset
Fever
Malaise
Visable bulge on buttock

PE: Erythema, induration, swelling, drainage

A

Perianal abscess

37
Q 
Asymptomatic
Biliary colic (pain)
Cholecystitis (inflammation/infection)
Choledocholithiasis
Cholangitis (life threatening obstruction when stone gets impacted or impacts bile duct) 
RUQ Pain, crescendo/decrescendo
A

Cholelithiasis

38
Q

Constant and severe RUQ pain
Radiation to shoulder
Fever, N/V

A

Cholecystitis

39
Q

Charcot’s triad: Fever, RUQ pain, jaundice

Reynolds Pentad: above +sepsis, mental status change

A

Ascending Cholangitis

40
Q

Asymptomatic
Abnormal LAE’s
Cholangitis

Complications:
Stones
Strictures Due to inflammation
and fibrosis
Cholangiocarcinoma (screen with MRI every year for this)
Higher risk of colon cancer in patients with UC

A

Primary Sclerosing Cholangitis (PSC)

41
Q

Eriology of Cholelithiasis

A 
MC cholesterol
Black pigment (darker and harder) 
Brown pigment (bacteria-brown and softer)
42
Q

Diagnostic test of choice for ascenginf cholangitis

A

Endoscopy (ERCP)

43
Q

Test for PSC

A

Cholangiogram

MRCP -minimally invasive and prevents introduction of bacteria to bild duct

44
Q

Eriology of GB ca

A

Adenocarcinomas

45
Q 
N/V/D 
Abd. Pain 
Fever, Chills, HA
~ 4 hr after ingetsion
Summer months

Ham and other pork products, poultry, baked goods, salads)

A

Staphylococcal Food Poisoning

46
Q

Sudden onset of nausea and vomiting Incubation period 1-6 hours

Abdominal cramps, watery diarrhea, nausea Incubation period 10-12 hours

Freid rice

A

Bacillus cereus Food Posioning

47
Q

Canned food

Lassitude, progressive weakness and vertigo

A

Clostridium botulinum Food Posioning

48
Q

14h to 5 days

Abrupt onset of profuse watery diarrhea with flecks of mucus (“rice water stool”) *HM

Mild to severe/life-threatening dehydration Fever in <5%

A

Vibrio cholerae

49
Q

Incubation: 1-3 days
Watery diarrhea, abdominal cramps, low-grade fever

frutit, uncooked veggies

A

Enterotoxigenic E. coli (ETEC)

50
Q

Fever, Vomiting, Diarrhea, Dehydration

infant

51
Q

Vomiting, abdominal cramps, diarrhea, low-grade fever

Food, water, swimming pools, shellfish (heat- resistant)
Cruise

52
Q

Asymptomatic in most children

Acute
1-4 week incubation
Loose, foul-smelling stools Steatorrhea: fat malabsorption
Cramping, bloating, nausea
Anorexia, malaise, weight loss
No blood in stools

Chronic → growth impairment

Bever

A

Giardia duodenalis

53
Q

Loose stools to massive watery or grossly bloody diarrhea

Severe abdominal cramping relieved by defecation

Bacteremia, meningitis, abscesses
Gastroenteritis less common

poultry

A

Campylobacter

54
Q

Prodrome: abdominal cramps & mild fever

Non-bloody diarrhea within hours, progressing to bloody diarrhea within 1-2 days

grounf beef

A

STEC: Shiga toxin producing E. coli

55
Q

Incubation: 6-48 hours

Fever, abdominal cramping, nausea, vomiting, & chills

Diarrhea watery, less commonly frankly bloody

eggs

A

Nontyphoidal Salmonella (NTS) Enterocolitis

56
Q

Asymptomatic colonization Amoebic dysentery
Amoebic colitis
Liver abscess

tropical areas w/ poor sanitation

A

Amoebiasis

57
Q

Chills, sweats, headache, malaise Cough, sore throat
Fever

Psychosis & confusion

Pain, constipation, N/V/D

“rose spots” – faint salmon-colored maculopapular rash on truck

Hepatosplenomegaly

A

Typhoid Fever

58
Q 
Abd pain radiating to back
N/V
Agitation
Abd distension
Guarding

Cullen, grey turner

Pseudocyst- only drain if causing sx
Alcoholic

A

Acute Pancreatitis

59
Q

Weight loss, abd pain radiaitng to back
Loose, foul smelling stools (steatorrhea), diabetes

alcoholic

A

Chronic Pancreatitis

60
Q

Amylase and lipase nrml or mildly elevated

Abx plain film- shows calcifications in pancreatic ducts

CT, MRI or EUS establishes dx

Honeycomb, ductal dilation

A

Chronic Pancreatitis

61
Q

Incubation period ~ 30 d
Excreted in stool 1-2 wks before onset

Flu like sx, fatigue, loss of appetite, nausea
Dark urine, pale feces, scleral icterus, jaundice, tender & enlarged liver

raw shellfish

A

Hepatitis A

62
Q

Incubation period 15‐45 days
Infection usually subclinical (esp in children and YA)

Undercooked pork or wild game

A

Hepatitis E

63
Q

1‐4months
Malaise, rash, fever, arthralgia/arthritis

Anorexia, nausea/vomiting, abdominal pain

May have jaundice and tender liver on exam

extrahepatic: Polyarteritis nodosa, glomerulonephritis

IDU, YA male

A

Hepatitis B Virus

64
Q

blood transmitted

concurrent with Hep B

A

Hepatitis D

65
Q

Clinically indistinguishable from other hepatitis causes

Asymptomatic or mild constitutional sx

HIV co-infection → ↑progression to fibrosis, blunted immune recovery, ↑ morbidity and mortality

Slow progression to liver dz

IDU, sexual

A

Hepatitis C

66
Q

Pain, diarrhea or obstipation, fever

LLQ pain MC (bc in sigmoid colon)

A

Diverticulitis

67
Q

MC cause of hematochezia

Painless, profuse bleeding

A

Diverticular Hemorrhage

68
Q

acute-onset, continued pain; nausea, vomiting; bloody diarrhea

Pain out of proportion to exam

A

Acute Mesenteric Ischemia

69
Q

Weight loss, chronic diarrhea, bleeding or anemia, recent abx

Recurrent abdominal pain or discomfort
at least 3 days/mo in the last 3 months
+ at least two of the following:

Pain improves w/ defecation
Onset associated w/ a change in bowel habits
Onset associated w/ a change in stool form

A

Irritable Bowel Syndrome

70
Q

RLQ pain

Low fever, nausea, anorexia

A

Appendicitis

71
Q

Occult or overt bleeding, anemia, abdominal pain, change in bowel habits
NSAID in high conc

A

NSAID Colopathy

72
Q

Anorexia, muscle cramps, paresthesias, irritability

Advanced deficiency may cause:
“wet beriberi”‐ cardiovascular syndrome

“dry beriberi”‐peripheral and the central nervous
systems (wernicke encephalopathy, Korsakoff syndrome)

A

B1

Thiamine Deficiency

73
Q

cheilosis, angular stomatitis, glossitis, seborrheic dermatitis, weakness, corneal vascularization, anemia

A

B2

Riboflavin deficiency

74
Q

Anorexia, weakness, irritability, mouth soreness, glossitis, stomatitis, and weight loss

Advanced deficiency: triad of the three D’s (pellegra): dermatitis, diarrhea, and dementia

A

B3

Niacin defieiency

75
Q

Mouth soreness, glossitis, cheilosis, weakness, and irritability, peripheral neuropathy, a pellagra‐like syndrome, anemia, and seizures

A

B6

Pyridoxine defieiency

76
Q

Loss of appetite and weight loss , weakness,
sore tongue, headache, heart palpitations.
Can slow growth rat.
Greater risk to give birth to low birth weight
preamuture infants, neural tube defects

A

B9

Folate deficiency

77
Q 
Macrocytic anemia (pernicious anemia), glossitis,
peripheral neuropathy, weakness, hyperreflexia, ataxia, loss of proprioception, poor coordination, and affective behavioral changes

Neurologic defects

A

B12 deficiency

78
Q

Scurvy: hemorrhagic skin lesions, abnormal osteoid and dentin formation

Fatigue, depression, & CT defects, (gingivitis, petechiae, rash) internal bleeding, impaired wound healing

Impaited bone growth in children

A

Vitamin C

Ascorbic Acid defieincy

79
Q

Night blindness, dryness of the conjunctiva, Bitot’s spots (white patches on the conjunctiva), ulceration and necrosis of the cornea (keratomalacia), perforation, endophthalmitis, hyperkeratosis

A

vit A deficiency

80
Q

Important for calcium homeostasis and metabolism → bone growth and immune system

A

vit D deficinecy

81
Q

Mild hemolytic anemia

Neurological deficits (areflexia, gait disturbances, decreased vibration and proprioception, and ophthalmoplegia)

A

Vit E deficiency

82
Q

Easy bruisability and mucosal bleeding (especially epistaxis, GI hemorrhage, menorrhagia, and hematuria)

A

vit K deficiency

Clin Med II (19 decks)

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